Effects of short-acting exenatide added three times daily to insulin therapy on bone metabolism in type 1 diabetes

Nicklas J Johansen, Thomas F Dejgaard, Asger Lund, Camilla Schlüntz, Bolette Hartmann, Jens J Holst, Tina Vilsbøll, Henrik U Andersen, Filip K Knop

Abstract

AIM: To evaluate the efficacy of the short-acting glucagon-like peptide-1 receptor agonist, exenatide, added to insulin therapy in type 1 diabetes on bone mineral density and bone turnover markers.

MATERIALS AND METHODS: In a randomized, double-blinded, parallel-group trial, 108 individuals with type 1 diabetes aged 18 years or older on basal-bolus therapy with HbA1c 59-88 mmol/mol (7.5%-10.0%) and body mass index of more than 22.0 kg/m2 were randomized (1:1) to preprandial subcutaneous injection of 10 μg exenatide (Byetta) before breakfast, lunch, and dinner over 26 weeks as add-on treatment to insulin therapy.

RESULTS: Exenatide elicited a body weight reduction of 4.4 kg compared with placebo, but no between-group differences in bone mineral density, as assessed by whole-body, hip, lumbar, and forearm dual-energy X-ray absorptiometry following 26 weeks of treatment, were observed. Fasting plasma levels of C-terminal telopeptides of type I collagen, a marker of bone resorption, and amino-terminal propeptide of type I procollagen, a marker of bone formation, were unchanged by exenatide compared with placebo after 26 weeks.

CONCLUSIONS: Despite an exenatide-induced body weight reduction, no changes in bone metabolism were observed with exenatide added to insulin therapy in type 1 diabetes after 26 weeks.

OriginalsprogEngelsk
TidsskriftDiabetes, Obesity and Metabolism
Vol/bind24
Udgave nummer2
Sider (fra-til)221-227
Antal sider7
ISSN1462-8902
DOI
StatusUdgivet - feb. 2022

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